Low TSH and low T4 on desiccated thyroid


I am new to the forum. Visiting the dr a few days back with symptoms such as insane hot flushes which have been getting worse over the last 3 month, massive hair loss, fatigued, etc

T4 9.1 (10.0-19.0)

TSH 0.48 (.50-4.00)

T3 4.1 (3.5-6.5)

Dr at a loss so going the Endo tomorrow.

This is the second time this has happened, last time I went off thyroxine to desiccated.

What can I expect?


11 Replies

  • Linda4444 I don't take NDT but from what I have read when taking NDT it will suppress TSH and FT4 will be lower in range. It's the FT3 that's important.

    What are your vitamins and mineral levels like? Deficiencies can cause thyroid hormone not to work properly, also symptoms like hair loss, fatigue, etc. It would be a good idea to get the following tested


    Vit D



    and address any deficiencies to get them all at their optimal level.

    Are you of an age where hot flushes can be attributed to menopause?

  • Hi, thanks for the quick reply. I am a little low on vit D but everything else has been tested and well within range. I am post menopausal and am being started on HRT but my levels are normal.

  • Sorry for sounding suspicious, but who told you your results were well in range? If it was people on this forum then I'll believe it. If it was a doctor I'd suggest getting a second opinion - us.

    The reason I say this...

    Imagine you had a ferritin result of 12 with a reference range of 15 - 150. Your doctor may give you a prescription for iron supplements for three months. Let's say your ferritin rises to 30. Your doctor would almost certainly say that was well in range and so you would be taken off iron.

    But in order for your body to be able to make proper use of thyroid hormones your ferritin needs to be higher. Most of us feel better with a ferritin level of 70+, although it shouldn't go higher than about 110 or 120. Note these numbers I'm quoting are all based on having a reference range of 15 - 150. Different reference ranges would change the numbers I'm quoting.

    So... do you have records of what your levels and reference ranges actually are for ferritin, vitamin B12, vitamin D and folate? If you do you could write them into a new post and ask for feedback.

  • Hi, it was my GP. Here are my levels

    Hydroxy vit d 45

    Ferritin 56


  • Vit b12 is 573

  • Do you have the reference ranges for those results, and the units of measurement. Americans (possibly Canadians as well? I'm not sure) use different units of measurement to the UK in many cases. It makes a big difference to the interpretation of results, and I don't know where your tests were done.

  • Welcome to the forum, Linda4444.

    The T3 in NDT can suppress TSH and FT4 will usually be significantly lower than when taking Levothyroxine. Most patients on NDT feel better with FT3 in the top third of range ie >5.5 so consider increasing the dose you take.


    I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • You'd expect low T4 and low TSH when taking any meds that include T3 (like NDT), but your FT3 is still pretty low in range, which suggests you need a dose increase. But you also need to be sure that your ferritin, B12, folate and D3 are optimum. The hot flushes could be adrenal-related or menopause related.

  • low vitamin D can cause ho flushes too. I have to supplement after parathyroid removed and know I need to supplement next months's vitamin D when flushes get worss

  • New Endo today said to start back on thyroxine 100mcg for 1 month and redo tests. Said the NDT can't be properly monitored and contains more than just natural stuff. Had an ultrasound on thyroid, no nodules but was told it is tiny. Said I need to up my vit d to more than 75 and go on HRT.....

  • All tablets (including levo) contain stuff that isn't the active ingredient - they are called fillers, and it is what turns an active ingredient into a pill. I think the problem is most likely to be that your Endo only knows how to interpret the results of patients on Levo.

    Since NDT is made out of thyroid tissue from pigs there is a possibility that the pills contain miniscule amounts of T2, T1, and calcitonin which are naturally found in the thyroids of pigs and humans. What kind of NDT have you been taking, just out of curiosity? Is it prescribed or do you buy it over the internet?

    I can't help you with the HRT, sorry, I don't take it.

    How do you feel about going back on Levo? I'm assuming you went on NDT in the first place because you didn't get on with Levo? Did NDT improve anything for you? Because there are still other choices or combos you could try. There are basically three treatments for hypothyroidism - Levo (T4), T3 or NDT. They can also be taken in combination which works for some people.

    One final question - how long a gap did you leave between your last dose of NDT and getting the blood drawn for the test that gave the results you've quoted?

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